Renal actinomycosis presenting as uro-cutaneous fistula

Christian Diab; Ahmad Almarzouq; Oluyomi Ajise; Sapha Barkati; Jean Tchervenkov; Sero Andonian

doi:10.1016/j.eucr.2019.101054

Renal actinomycosis presenting as uro-cutaneous fistula

Urol Case Rep. 2019 Oct 17:28:101054. doi: 10.1016/j.eucr.2019.101054. eCollection 2020 Jan.

Authors

Christian Diab¹, Ahmad Almarzouq¹, Oluyomi Ajise², Sapha Barkati³, Jean Tchervenkov⁴, Sero Andonian¹

Affiliations

¹ Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.
² Division of Pathology, McGill University, Montreal, QC, Canada.
³ Division of Medical Microbiology and division of Infectious Diseases, McGill University, Montreal, QC, Canada.
⁴ Division of Hepato-biliary Service, Department of Surgery, McGill University, Montreal, QC, Canada.

Abstract

Renal actinomycosis is a rare clinical entity. Diagnosis is usually made after resection. A 36-year-old male presented with uro-cutaneous fistula and left xanthogranulomatous pyelonephritis. He was offered left open radical nephrectomy. Intra-operatively, there was "woody" inflammation of the left kidney fistulizing to the splenic flexure of the colon. We successfully resected it and a segment of the colon that had fistulized. His tissue cultures grew Actinomyces odontolyticus. Post-operatively, he received 6 weeks of intravenous beta-lactam antibiotic. He recovered well without any complications. In conclusion, renal actinomycosis can be challenging to diagnose, operate and eradicate. Perioperative considerations are presented for successful management.

Keywords: Actinomycosis; Disease management; Infection; Kidney calculi; Pyelonephritis xanthogranulomatous; Urinary fistula.

Publication types

Case Reports